Women's Adventure Fitness Boot Camp in San Jose, bootcamp for women, adventure boot camp, womens fitness program, womens weight loss, exercise camp, womens camp, exercise, workout programs, outdoor exercise

San Jose Adventure Boot Camp for Women Registration

Adventure Boot Camp Options:

Summer Jump Start Boot Camp - 3 Week Express Camp
Monday through Friday
May 6-24th

UNLIMITED Days - Only $197!

Get ready for a summer jump start!

Boot Camp Fitness Jumpstart - 4 week program
Monday through Friday

5-day/week Program - Only $297 per camp
3-day/week Program - Only $227 per camp

This program is for someone who's ready to jumpstart their fitness program and get some serious mind-blowing results!

We recommend you attend 5-days per week to experience the greatest results. A minimum of 3-days per week is recommended to maintain your current fitness level and weight.

Adventure Boot Camp "Inner Circle" Membership
Monday through Friday
12-Month (10 camp) Program

5-day/week Program - Only $197 per month
3-day/week Program - Only $167 per month

Adventure Boot Camp "Summer Circle" Membership
Monday through Friday
6-Month (5 camp) Program

5-day/week Program - Only $237 per month
3-day/week Program - Only $179 per month

Monday through Friday

We have a confession to make. San Jose/Campbell Adventure Boot Camp for Women is addictive. This program has quickly become our most popular. Campers tell us they are addicted to boot camp and many of them refer to themselves as "lifers". We know we've got a secret ingredient - fun, thrilling workouts that leave you begging for more. Every day at camp is different as we take you on a fitness adventure so you'll never have a ho-hum moment!

It's perfect for ladies who are tired of "spinning their wheels" and getting no where with their fitness program. If you want to reclaim your attractive, energetic body once and for all...this is for you!

Inner CIrcle Membership Billing: Every 30 days you will be automatically billed the discounted rate of only $197 for 5 days per week, or $167 for 3 days per week, for a minimum 12-month term (10+ camps).

Summer CIrcle Membership Billing: Every 30 days you will be automatically billed the discounted rate of only $237 for 5 days per week, or $179 for 3 days per week, for a minimum 6-month term (5 camps).

This program offers weekly attendance to one boot camp session per day during scheduled regular boot camps, based on the number of days selected.
(see the calendar on www.sanjosebootcamp.com NOTE: The calendar may change during the year)

Submitting registration does not guarantee your acceptance into this program. SJABC reserves the right to refuse service to anyone who fails to meet, to agree to, or to abide by, our policies and program procedures; or, who we feel, based on our professional opinion & evaluation, this program is not appropriate.

Registration Form

Personal Information

Participant Full Name

Billing Address

City

State

ZIP (Billing)

Profession

Country

Date of Birth

(mm/dd/yyyy)

Phone Number (Billing)

Cell Phone Number - *Required for notification*

Work Number

Primary Email Address

Self Assessment & Additional Information

I rate my current fitness level as a (1-10), ten being high.

I was referred by:

How did you hear about us?:

Please specify publication / website / friend or other referral:

This is my first camp:

Yes | No

If you answered "no", when was the last camp you attended:

My Main goal is:

Name of Emergency Contact & Phone Number

Camp and Payment Information

What camp are you joining? Please check camp calendar for availability
What time are you attending? Please check camp calendar for availability
Choose your camp frequency and cost. Please check camp calendar for availability.
If you have a Special Promotional Code, please enter it here. Your code will automatically provide you with the discount and/or promotional offer. Please note: Your discount will be reflected on your credit card statement, even though it will not be reflected on this page, it WILL be reflected on your credit card statement. You will not be charged the full price.
Form of payment: Please note: We no longer accept checks for payment. You must enter a credit card number below to receive a confirmation email and to reserve your spot. Please note: if you are using a "Gift Certificate" for payment, please enter the gift certificate code in the box above. We will contact you if there is a balance after applying your gift certificate.

Please note: The "Express" Camp option is only available when specifically offered on the Calendar page.

Credit Card Information
For security reasons, your credit card information is not stored or saved within our system. Your credit card information will be entered after your complete this screen. Please provide correct billing address and phone. Credit Card Merchant Services

MEDICAL HISTORY (If you are a returning camper, only complete the sections that have changed.)

Medical History

1. Are you allergic to any medication (aspirin, penicillin, sulfa, etc.)?

List Medications:

2. Do you take any prescribed medication on a permanent or semi-permanent basis?

List Medications:

3. Do you have a seizure disorder (epilepsy)?

List Medications:

4. Do you have diabetes Adult or Juvenile?

5. Have you ever been found to be anemic (low blood count)?

6. Do you have High Blood Pressure (hypertension)?

List Medications:

7. Do you have or have you ever had the following diseases?

Heart Disease:

Lung Disease:

Kidney Disease:

Liver Disease:

8. Do you have asthma?

List Medications:

9. Have you ever had a severe neck injury?

Describe:

10. Have you ever been knocked out?

Describe:

11. Do you wear glasses or contact lenses?

12. Have you had a broken bone or fracture in the past 2 years?

Describe:

13. Have you ever injured your back?

Describe:

14. Do you have back pain?

15. Have you had knee pain in the past 2 years that has disabled you for longer than a week?

Describe:

16. Do you have other physical conditions which cause pain?

Describe:

17. Detail any surgical procedures:

18. What are your goals for the next three months?

19. Have you had your body fat tested?

If yes, what percent is it?

20. Are you training for a specific event?
If yes, explain:

Release

NOTICE: It is wise to seek your doctors advice before beginning any health/fitness/nutrition program!

This release is entered into between the undersigned and San Jose Adventure Boot Camp for Women, its officers, subsidiaries, affiliates, and executors in addition to the City of Campbell, San Jose, Santa Clara County and/or Campbell Parks and Recreation Department. The purpose of San Jose Adventure Boot Camp for Women is to provide fitness instruction and coaching for various levels of athletes/individuals.

The undersigned hereby acknowledge that the following was explained to me and/or agree to the following:

1. Acknowledges that Brett A. Riesenhuber and staff are not physicians and are not trained in any way to provide medical diagnosis, medical treatment, or any other type of medical advice.

2. Acknowledges that coaching/training is another tool for teaching athletes/individuals about themselves, but that San Jose Adventure Boot Camp does not guarantee neither good nor bad will occur nor guarantees the training advice given by Brett A. Riesenhuber including San Jose Adventure Boot Camp will produce good nor bad results.

3. Acknowledges that the undersigned has been told if they feel tired, feel pain or feel out of the ordinary in any way either related to your training, or otherwise, that the undersigned should contact a physician at once.

4. Acknowledges that boot camps, aerobic classes, martial arts, kick boxing, running, kung-fu, weight training, obstacle courses, and any other related sports are an extreme test of one's mental and physical limits and carry with it potential for damage or loss of property, serious injury and death. That the undersigned assumes the risks of participating in these types of events/activities including the elements of a natural environment, that they are fit, and they have a regular medical physician they can contact regarding any medical problems that they might develop. The undersigned expressly waive, release, discharge and agree not to sue from any liability of death, disability, personal injury, or action of any kind San Jose Adventure Boot Camp for Women for the undersigned participating in said sporting events and/or training for said sporting events.

The Undersigned agrees that this is the full agreement between the parties, that San Jose Adventure Boot Camp for Women including Brett Riesenhuber nor anyone else has not verbally contradicted any of the terms of this release and that the undersigned has entered into this agreement free and voluntarily without force or coercion.

Customer client agrees to confidentiality with respect to San Jose Adventure Boot Camp for Women and all services provided by same. The undersigned agrees to refrain from disclosing, directly or indirectly, any and all aspects of San Jose Adventure Boot Camp for Women. The undersigned agrees to a non-compete within a 50 mile radius of San Jose, California for a period of 5 years from date of participation.

Checkmark the Following:

	I agree to be coachable/trainable during my 4 weeks of boot camp in order to achieve my health and fitness goals.
	I commit to give 100% effort to myself and my fitness at each class and the remaining 23 hours per day.
	I agree not to eat or say the words Twinkie, Donuts, Ho-Ho's, Ding Dong, or Cup Cake during the course of Boot Camp. Any violation will result in twenty push-ups and one lap per occurrence.
	I agree to set my alarm and show up for Boot Camp ON TIME every day unless it is an excused absence from my doctor or pre-approved with Boot Camp directors. Any violation will result in twenty push-ups and one lap per occurrence.
	I commit to respect my coach and my peers by not talking while the coach is instructing. If the coach is speaking it is likely information that my peers and I need to hear to make our boot camp experience more safe and effective.
	I understand that diet and nutrition will effect my fitness goals and performance during boot camp. I choose to commit to eating and drinking foods and beverages that will accelerate my success AND consume no alcohol for my 4 week program.
	I agree to show up for Boot Camp every day that I have registered for.
	I understand that photos or video may be taken during the course of my involvement in Boot Camp, which may be used for promotional purposes and I give my permission for their use.
	I understand the following refund/makeup policy: 4-Week Jumpstart Refund Policy: If you are unable to attend camp due to circumstances out of your control, we can offer you a refund if you notify us prior to your session start date however we will charge a $50.00 cancellation fee. If we are notified after your session begins, we can only give you a credit to be used towards another boot camp. This credit is nontransferable. There is no cash refund. This is not negotiable. Makeup Policy: We do NOT offer make-up days. You must commit to the program for which you have signed up; and in order to get results, you need to be consistent in your workouts. We recommend you attend 5-days per week to experience the greatest results. A minimum of 3-days per week is recommended to maintain your current fitness level and weight.
	I will bring a positive attitude, and expect to have fun!

Agreement and Signature

I agree to the terms stated above. This agreement also incorporates numerous additional Terms and Conditions as well as an Express Assumption of Risk Agreement and Release of Liability and Indemnity Agreement ("Additional Terms and Conditions"). You must check the box before proceeding and you must view the Additional Terms and Conditions by clicking here. By checking the box and clicking the "Submit" button below, you hereby represent that you have read the Additional Terms and Conditions in its entirety and you specifically acknowledge and agree to be bound by its contents.

Electronic Signature

Date (MM/DD/YYYY)

- By submitting this form you agree to all terms and checkboxes listed above even if not marked.

Prime Physique, LLC.
DBA San Jose Adventure Boot Camp
3635 Union Avenue
San Jose, CA 95124
SanJoseBootCamp2@gmail.com
408-841-7605

For More Information, e-mail: SanJoseBootCamp2@gmail.com